9.6 million US Children (13%) have no health insurance, Latino and African-American children account for 57% of uninsured children, although comprising only 37% of all US Children. Studies show that being uninsured has a negative impact on children's health, healthcare, and mortality, however, insuring children results in improved health and healthcare. About 70% of uninsured US children (6 million) are eligible for but not enrolled in Medicaid or the Children's Health Insurance Program (CHIP), innovative strategies are needed to insure more children and eliminate disparities. This is the first randomized controlled trial comparing the effectiveness of parent mentors (PMs) to traditional Medicaid/CHIP outreach and enrollment in insuring uninsured minority children. The primary study aims are to evaluate whether PMs are more effective and more cost-effective than traditional Medicaid/CHIP outreach and enrollment in uninsured children. The secondary aim is to determine whether children who obtain health insurance experience improvements in healthcare access, health status, use of services, and other health outcomes.

Subjects will be 300 Dallas County uninsured and Medicaid/CHIP eligible Latino and African-American children (90% of insured children) and their parent/guardian. Subjects will be randomized to PMs or a control group receiving traditional Medicaid/CHIP outreach. PMs are experienced parents who have a child currently covered by Medicaid/CHIP. PMs will undergo intensive training, and will be paired with intervention subjects and their families, for whom they will provide information on Medicaid/CHIP eligibility, help complete/submit insurance applications, act as a liaison, and assist in maintaining coverage. Primary outcomes will include obtaining health insurance, coverage continuity, time interval to obtain coverage, parental satisfaction with the process of obtaining insurance and costs; secondary outcomes will include access to care, health status, use of services, quality of life, Parental satisfaction, financial burden, and missed school/parental work days. Subjects will be contacted monthly for 1 year to monitor outcomes by a blinded assessor. Achievement of study aims has the potential to contribute to reducing racial/ethnic disparities, and advancing knowledge and practice of child health policy. This intervention could serve as a national model for insuring uninsured children and reducing racial/ethnic disparities in insurance coverage.

Further study details as provided by University of Texas Southwestern Medical Center:

Primary Outcome Measures:

Randomized Trial Questionnaire [ Time Frame: Baseline and Monthly for one year ] [ Designated as safety issue: No ]

Orally administered questionnaire for demographics and on-going record of obtaining and maintaining insurance for child-subject as reported by parent. This is to include number of days to obtain insurance and episodic coverage (loss and reinstatement of coverage). Additionally, monitoring and assessing direct healthcare costs, insurance enrollment fees and intervention costs. Outcomes will be monitored by a Research Technician who will be blinded to the subject group assignment.

Secondary Outcome Measures:

Health status and parental satisfaction [ Time Frame: Monthly for one year ] [ Designated as safety issue: No ]

Review of health status, quality of life for the child, access to healthcare, unmet healthcare needs, use of health services, and quality of pediatric care conducted orally via telephone or home visit. Parental satisfaction will be measured separately according to group assignment. Overall satisfaction will be be determined for each maneuver. On a five-point Likert scale & open-ended questions regarding satisfaction with obtaining health insurance.

After random assignment to the control group, minority low-income parents of a Medicaid/CHIP eligible child will receive only the traditional outreach regarding enrolling in Medicaid/CHIP.

Behavioral: Effects of Parent Mentors on Insuring Minority Children

After random assignment to the Parent Mentor group,the minority low-income parent of a Medicaid/CHIP eligible child will meet with a Parent Mentor to receive instruction and help on completing, submitting, and maintaining Medicaid/CHIP insurance for their child.

Eligibility

Ages Eligible for Study:

up to 18 Years

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

Yes

Criteria

Inclusion Criteria:

The parent/guardian is a primary caretaker of a least one child 0-18 years old who currently has no health insurance

The parent/guardian self-identifies the uninsured child as Hispanic/Latino, African-American/Black, or both

The uninsured child is eligible for either Medicaid or CHIP

The parent/guardian is willing to be contacted monthly by telephone, or in the form of a home visit (if no functioning telephone is present in the household).

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01264718

Locations

United States, Texas

University of Texas Southwestern Medical Center

Dallas, Texas, United States, 75235

UT Southwestern

Dallas, Texas, United States, 75390

Sponsors and Collaborators

University of Texas Southwestern Medical Center

Investigators

Principal Investigator:

Glenn Flores, M.D.

University of Texas Southwestern Medical Center

More Information

No publications provided

Responsible Party:

Glenn Flores, Director, Division of General Pediatrics Professor of Pediatrics, Clinical Sciences, and Public Health The Judith and Charles Ginsburg Chair in Pediatrics Director, Academic General Pediatrics Fellowship, University of Texas Southwestern Medical Center